The influence of ankle joint movement on knee joint kinesthesia at various movement velocities

An Ankle Joint Flexion and Extension Movement-Monitoring Device Based on Pressure Sensors

Ankle joint flexion and extension movements play an important role in the rehabilitation training of patients who have been injured or bedridden for a long time before and after surgery. Accurately guiding patients to perform ankle flexion and extension movements can significantly reduce deep vein thromboembolism. Currently, most ankle rehabilitation devices focus on assisting patients with ankle flexion and extension movements, and there is a lack of devices for effectively monitoring these movements. In this study, we designed an ankle joint flexion and extension movement-monitoring device based on a pressure sensor. It was composed of an STM32 microcontroller, a pressure sensor, an HX711A/D conversion chip, and an ESP8266 WiFi communication module. The value of the force and the effective number of ankle joint flexion and extension movements were obtained. An experimental device was designed to verify the accuracy of the system. The maximum average error was 0.068 N; the maximum average relative error was 1.7%; the maximum mean-squared error was 0.00464 N. The results indicated that the monitoring device had a high accuracy and could effectively monitor the force of ankle flexion and extension movements, ultimately ensuring that the patient could effectively monitor and grasp the active ankle pump movement.

Selective effect of static stretching, concentric contractions, and a one-leg balance task on ankle motion sense in young and older adults

BACKGROUND

Being aware of ankle movement and motor control has a critical role in maintaining balance during functional activities such as standing, walking, and running. Since the somatosensory system declines with aging, this is even more important for older adults.

RESEARCH QUESTION

How do different exercise modalities (static stretching, one-leg balance task, concentric contractions, and control) acutely influence ankle motion sense in young and older adults?

METHODS

Seventeen young and fifteen older participants performed four different intervention protocols (static stretching, one-leg balance task, concentric contractions, and control) in random order. Each session comprised measurements of ankle motion sense in plantar flexion (PF) and dorsal flexion (DF) directions prior to and after an intervention protocol. Average threshold levels (in degrees) of motion sense detection were calculated from three trials in each direction (PF/DF).

RESULTS

A lower threshold of motion ankle sense was observed for young adults compared to older adults regardless of the exercise modality and the direction of the movement (p < 0.001). However, the changes in PF and DF ankle motion senses followed a similar trend in both groups during the three exercise modalities: static stretching increased ankle motion sense threshold (PF: 14% and 5%; DF: 19% and 11% in young and older adults, respectively), concentric contractions decreased ankle motion sense threshold (PF: -24% and -14%; DF: -19% and -21% in young and older adults, respectively), and the one-leg balance task did not significantly influence the ankle motion sense threshold (PF: -1% and -2%; DF: 6% and 1% in young and older adults, respectively).

SIGNIFICANCE

Based on these results, static stretching should not be performed before ankle activities that require a good balance, precision, and coordination. Concentric contractions could be recommended before activities that challenge our postural stability.

Selective effect of static stretching, concentric contractions, and a balance task on ankle force sense

Proper ankle motor control is critical for balance in the human body during functional activities such as standing, walking, and running. Different exercise modalities are often performed during the same training session where earlier activities may influence later ones. The purpose of the current study was to determine the acute effects of different exercise modalities on ankle force sense. Seventeen subjects performed four different intervention protocols (static stretching, balance task, concentric contractions, and control) in random order. Each session comprised measurements before and after the intervention protocol of the force sense of the ankle plantar flexors (PF) and dorsal flexors (DF) at 10% and 30% of maximal voluntary isometric contraction (MVC). Absolute errors (AE) were calculated separately for each force level and muscle group. An overall PF error (PF-SUM = PF at 10%MVC + PF at 30%MVC), DF error (DF-SUM = DF at 10%MVC + DF at 30%MVC) and ankle error (PF-DF-SUM = PF-SUM + DF-SUM) were also calculated. The main effect of time generally revealed that ankle force sense was significantly reduced after static stretching (PF-DF-SUM: Pre: 6.11±2.17 Nm, Post: 8.03±3.28 Nm; p < 0.05), but no significant differences were observed for the concentric contractions (PF-DF-SUM: Pre: 6.01±1.97 Nm, Post: 6.50±2.28 Nm) and the balance task (PF-DF-SUM: Pre: 5.25±1.97 Nm, Post: 5.50±1.26 Nm). The only significant interaction was observed for the PF-DF-SUM (F = 4.48, p = 0.008) due to greater error scores after stretching (+31.4%) compared to the concentric (+8.2%), balance (+4.8%), and control (-3.5%) conditions. Based on these results, static stretching should not be performed before activities that require a high ankle force sense such as balance, coordination, and precision tasks.

The Effects of Cryotherapy on Knee Joint Position Sense and Force Production Sense in Healthy Individuals

The proprioceptive information received from mechanoreceptors is potentially responsible for controlling the joint position and force differentiation. However, it is unknown whether cryotherapy influences this complex mechanism. Previously reported results are not universally conclusive and sometimes even contradictory. The main objective of this study was to investigate the impact of local cryotherapy on knee joint position sense (JPS) and force production sense (FPS). The study group consisted of 55 healthy participants (age: 21 ± 2 years, body height: 171.2 ± 9 cm, body mass: 63.3 ± 12 kg, BMI: 21.5 ± 2.6). Local cooling was achieved with the use of gel-packs cooled to -2 ± 2.5°C and applied simultaneously over the knee joint and the quadriceps femoris muscle for 20 minutes. JPS and FPS were evaluated using the Biodex System 4 Pro apparatus. Repeated measures analysis of variance (ANOVA) did not show any statistically significant changes of the JPS and FPS under application of cryotherapy for all analyzed variables: the JPS’s absolute error (p = 0.976), its relative error (p = 0.295), and its variable error (p = 0.489); the FPS’s absolute error (p = 0.688), its relative error (p = 0.193), and its variable error (p = 0.123). The results indicate that local cooling does not affect proprioceptive acuity of the healthy knee joint. They also suggest that local limited cooling before physical activity at low velocity did not present health or injury risk in this particular study group.

Adaptive Staircase Measurement of Hand Proprioception

Clinicians and researchers often need to measure proprioception (position sense), for example to monitor the progress of disease, to identify the cause of movement or balance problems, or to ascertain the effects of an intervention. While researchers can use sophisticated equipment to estimate proprioceptive acuity with good precision, clinicians lack this option and must rely on the subjective and imprecise methods currently available in the clinic. Here we describe a novel technique that applies psychometric adaptive staircase procedures to hand proprioception with a simple tablet-style apparatus that could easily be adapted for the clinic. We report test-retest reliability, inter-rater reliability, and construct validity of the adaptive staircase method vs. two other methods that are commonly used in clinical settings: passive motion direction discrimination (PMDD) and matching. As a first step, we focus on healthy adults. Subjects ages 18–82 had their proprioception measured with each of the three techniques, at the metacarpophalangeal joint in the second finger of the right hand. A subset completed a second session in which the measures were repeated, to assess test-retest reliability. Another subset had the measurements done by two different testers to assess inter-rater reliability. Construct validity was assessed using stepwise regression on age and activity level, and correlations calculated across the three methods. Results suggest that of the three methods, the adaptive staircase method yields the best test-retest reliability, inter-rater reliability, and construct validity. The adaptive staircase method may prove to be a valuable clinical tool where more accurate assessment of proprioception is needed.

Assessing Proprioception: A Systematic Review of Possibilities

Proprioception is a vital aspect of motor control and when degraded or lost can have a profound impact on function in diverse clinical populations. This systematic review aimed to identify clinically related tools to measure proprioceptive acuity, to classify the construct(s) underpinning the tools, and to report on the clinimetric properties of the tools. We searched key databases with the pertinent search terms, and from an initial list of 935 articles, we identified 57 of relevance. These articles described 32 different tools or methods to quantify proprioception. There was wide variation in methods, the joints able to be tested, and the populations sampled. The predominant construct was active or passive joint position detection, followed by passive motion detection and motion direction discrimination. The clinimetric properties were mostly poorly evaluated or reported. The Rivermead Assessment of Somatosensory Perception was generally considered to be a valid and reliable tool but with low precision; other tools with higher precision are potentially not clinically feasible. Clinicians and clinical researchers can use the summary tables to make more informed decisions about which tool to use to match their predominant requirements. Further discussion and research is needed to produce measures of proprioception that have improved validity and utility.

The effects of cryotherapy on proprioception system

Proprioception plays an important role in the complex mechanism of joint control. Contemporary sport activities impose extremely high physical demands on athletes. Winter sports are played in areas with excessively low temperatures. Moreover, many athletes are subjected to treatments that involve local lowering of the body temperature before, during, and after physical activity. This work reviews the current knowledge regarding the influence of local cryotherapy on the proprioception system. The reviewed literature identified several tests that evaluate different aspects of proprioception. There is no universally agreed protocol, or clear set of criteria for test conditions. The outcomes of different tests and assessments of cryotherapy procedures using different cold modalities are poorly correlated. In general, the published results on the mechanism of cryotherapy effects on proprioception are not uniquely conclusive and are frequently contradictory. Additional high-quality research is required to explicitly answer the following questions: (1) whether local cryotherapy influences all aspects of proprioception; (2) whether the current methods of evaluation are adequate for the exploration of the relationship between cryotherapy and proprioception; and (3) whether the application of local cryotherapy is safe for athletes regarding proprioception. The review clearly showed that there is no comprehensive model relating cryotherapy and proprioception.

Kinaesthesia and Methods for its Assessment: Literature Review

In this review measurement techniques used for kinaesthetic sense assessment are presented. Kinaesthesia is an important part of human movement control and provides us with better understanding of specific movement system adaptations to fatigue, training and injury. Additionally, decreased kinaesthesia can be an injury predisposing factor, which stresses the necessity for its assessment in sports injury prevention programs. First, terminology and functional concept of kinaesthesia is presented in relation to other related concepts like proprioception and sensory-motor function. For better understanding, basic underlying neurological backgrounds are discussed in chapter two, encompassing peripheral sensory fields as well as the basics of the central processing. Additionally, factors affecting kinaesthesia and its adaptations to training are presented. Functional aspects are discussed, supporting the role of assessment of kinaesthesia in sports and rehabilitation. In the third chapter, a proposal for measuring methods classification is given. In the final chapter, different measuring protocols and their modifications are presented. Due to their usefulness in sports and injury prevention, methods for measuring sense of joint position, movement onset and active tracking are discussed in more detail. Possibilities and examples of their application to sports and sports injury rehabilitation settings are presented. Some basic guidelines are given of how to use these methods in training or for screening kinaesthesia.